Where are all the carbohydrates and which ones are best?

By Laura Stepp, MA RD LD CDE at LMC

We hear it all the time “I’m on a low carb diet” or “I don’t eat carbs”. We see it in the news and on social media. Are carbohydrates good or bad, do we choose them, avoid them or limit them?

bread_1What really is a carbohydrate? A Carbohydrate is a macronutrient and major energy source in our diet coming from plants. Carbohydrates can be simple or complex. Simple carbohydrates are fast and easy for the body to digest. Although in some situations this is good, people with diabetes or those interested in losing or maintaining weight loss want to choose complex carbohydrates. Complex carbohydrates are intact and whole foods: Whole grains, beans, fruits and vegetables. Complex carbohydrates are higher in FIBER.

If we all need carbohydrates to fuel our bodies, why do we hear about low carbohydrate diets? Highly processed foods (foods that are prepackaged, premade, fast foods) are generally low in fiber (and often high in sugar and calories) making it easier for us to over indulge which could result in too many total calories, weight gain and high blood sugar for someone with diabetes.

In general, all foods in moderation can fit into a healthy diet. For people with diabetes, moderating and portion controlling carbohydrates — especially starchy carbohydrates and fruit — and choosing higher fiber versions not only helps improve and balance blood sugar but may also help with weight loss.

Lower Fiber starches and fruits: White pasta, white bread, white rice, French fries, fruit juice, dried fruit and desserts

fruit_1High Fiber starches and fruits: Whole wheat breads and pasta, oatmeal, brown rice, whole potato or beans/legumes, whole fruit

A standard serving of carbohydrates is equal to 15 grams if reading a food label and a higher fiber choice is equal to 4 grams of fiber or more per serving. If there is no label, then measuring ½ cup cooked or using the palm of your hand (no fingers) is a good general guide for a serving of carbohydrates. For most people, 60 grams or four servings of carbohydrates is a normal and reasonable meal plan. Here is an example I use with my clients to show how much food can equal 60 grams.

3-4 oz skinless turkey
1 cup cooked butternut squash (1 choice)
1-2 cups cooked vegetable (not corn, peas or beans) (0-1 choice)
1 large green salad (oil & vinegar dressing)
1 palm size whole fruit (1 choice)
1 cup of milk or yogurt (1 choice)

This meal plan comes from the Diabetes Care and Education dietetic practice group of the American Dietetic Association

By using the above example as a template for preparing our own plates this holiday season, we will all be eating a very colorful and filling plant based meal.

Diabetes Self Management During the Holidays

By Laura Stepp, MA, RD, LD, CDE at LMC

Managing diabetes can be a daily struggle. The American Association of Diabetes Educators has a list of 7 Self-Care Behaviors to help people achieve and maintain a healthy lifestyle.

AADE7 Self-Care Behaviors ™
• Eating healthier
• Being physically active
• Monitoring blood glucose
• Taking medication as prescribed
• Solving problems in unusual situations
• Reducing the risk of complications
• Coping with stress and emotional issues

Each one of the behaviors takes time and patience to make apart of your new lifestyle. Let’s look at eating healthier. That can mean many different things depending on your current dietary intake and cultural background. Simply put eating healthier is first about portion control and limiting the number of carbohydrates (starches, fruit, milk/yogurt) per meal. Often, that’s more difficult than it sounds, especially during the holiday season. It’s November which means for most of us we are planning to enjoy at least one big meal with lots of potential carbohydrates. So, how can we eat what we love and love what we eat? Balance and moderation!

ThanksgivingFirst try to maintaining a normal meal pattern of 3 moderate sized meals consumed at approximately the same time. Keeping a regular meal time schedule will help prevent becoming overly hungry; this is especially important during the holidays

Second, balancing carbohydrate intake is important. For example, if dressing/stuffing or sweet potato casserole are dishes you look forward to all year let’s enjoy them! However, since they are a carbohydrate consider leaving the rolls which you can eat any day. This is a good way to help balance and moderate carbohydrate intake and blood sugar. Remember the hidden carbohydrate in the holiday meal – gravy! A little is good; a lot can mean a higher blood sugar and extra calories.

Last but not least, another way to help control and balance carbohydrate intake during the holidays is to remember veggies! Vegetables are very low in carbohydrates and calories and high in vitamins and minerals. One and a half cups of cooked vegetables or three cups raw are equal to one ½ cup of mashed potatoes (no gravy) – so add more vegetables to your plate!

From the American Institute for Cancer Research website: a colorful, lower carbohydrate and tasty addition to any holiday meal.

Photo Courtesy: Pioneer Thinking

Photo Courtesy: Pioneer Thinking

Beet Salad with Peaches and Walnuts
2 medium cooked red beets, sliced 1/4-inch
2 medium tomatoes, sliced 1/4-inch
Salt and freshly ground black pepper
1 small shallot, thinly sliced
2 Tbsp. minced mint leaves (reserve a few sprigs for garnish)
1 tsp. minced thyme (reserve a few sprigs for garnish)
2 Tbsp. extra virgin olive oil
1 Tbsp. lemon juice
1 tsp. honey
2 cups sliced peaches without skin (fresh or frozen)
1/3 cup toasted chopped walnuts
1/4 cup crumbled goat cheese (or feta)

On platter arrange beets and tomato slices. Season to taste with salt and pepper.

In large mixing bowl combine shallot, mint, thyme, oil, lemon juice and honey. Stir well to combine. Add peach wedges and gently toss to coat.

Arrange peach mixture over beets and tomatoes. Top salad with walnuts and cheese, garnish with mint and thyme sprigs and serve.

Makes 6 servings.

Per serving: 197 calories, 11 g total fat (2.5 g saturated fat), 22 g carbohydrate, 6 g protein, 2 g dietary fiber, 58 mg sodium.

Lexington Medical Center Welcomes Samir R. Shah, MD

Lexington Medical Center is pleased to welcome Samir R. Shah, MD to the hospital’s network of care as a surgeon at Lexington Surgical Associates. Offering exceptional care at three convenient locations, the board-certified surgeons at the practice specialize in general, vascular, thoracic, breast and colorectal surgical options, including conventional and minimally invasive surgery.

Samir Shah, MD

Samir Shah, MD

Dr. Shah graduated from Rutgers College in New Brunswick, New Jersey and earned his medical degree from St. Georges University School of Medicine in Grenada, West Indies. He went on to complete his surgical residency at Monmouth Medical Center in Long Branch, New Jersey before completing clinical and research fellowships for colon and rectal surgery at Indiana University School of Medicine in Indianapolis.

A member of the American College of Surgeons, the American Society of Colon and Rectal Surgeons, and a Society of American Gastrointestinal and Endoscopic Surgeons Candidate, Dr. Shah has professional certifications from the American Society of Colon and Rectal Surgeons for da Vinci® multiport surgery and neuromodulation. His extensive surgical experience includes benign and malignant rectal pathology with da Vinci robotic surgery, transanal endoscopic microsurgery and implantation of sacral nerve stimulators.

Dr. Shah is accepting new patients.

Lexington Surgical Associates
2728 Sunset Blvd., Suite 104
West Columbia, SC 29169
(803) 791-2722